When should you access support for an eating disorder?

Eating disorders can be extremely isolating; trapping the sufferer in a cycle of shame and guilt associated with their behaviours. We understand how difficult it is to address concerns with a loved one, however, noticing signs and symptoms and having a conversation about them is the first step in their recovery.

We spoke to Orri’s Clinical Director, Kerrie Jones, about when you should access support for a loved one…

1. As soon as you know that things are not OK

An instinct that something is not quite right is usually a good indicator of there being a problem. You may have noticed concerning changes to someone’s food intake or exercise habits, such as missing meals, intermittently fasting or exercising to compensate for food intake. These are all indicators of a more harmful or punishing relationship to food and eating. Instincts are usually right, so listening to them and addressing them is important – even if you are met with denial and refusal that there’s a problem.

2. When food or exercising starts to dictate life decisions that your loved one is taking

Over time, you may notice that someone seems less confident about going out. They may require lots of reassurance or information about what will be happening and when – especially around food plans. You may observe that a previously outgoing person prefers to spend an increasing amount of time alone; perhaps you hear them moving around a lot, looking flushed if you wander in and defensive if you ask what they have been doing. You may notice they are at the gym a lot or walking the dog more frequently. Again, these are really important changes to notice and raise. You may wish to consult a professional for advice on how to approach the situation.

3. Preparing meals, and meals themselves, becomes a challenge

For someone with an eating disorder, preparing and eating meals can become a very distressing time, with what seems like a ‘normal’ everyday routine becoming a battle ground – and an often upsetting and dreaded time for all involved.

Signs that things aren’t right present themselves in a number of ways: portions get smaller and the sufferer may fill up on drinks – water, diet coke, caffeine – as a way of managing their appetite. You may notice changes in how they eat with ‘rituals’ developing at the table: cutting food into small pieces, moving food around the plate, hiding food in napkins or under the plate or over chewing or taking a long time to eat. Perhaps they chew gum all the time, or frequently brush their teeth. The behavioural changes can be very noticeable or much more subtle and gradual, depending upon the individual.

Another area that can change is meal preparation. It can become very stressful if any suggestion or intervention is made that goes against what the individual feels they need at that time. You may find meals are being made and/or eaten separately. A preoccupation with what’s in the food can develop, with conversations around the number of calories and fat content being high in the agenda. Your loved one might insist on making separate food for themselves, perhaps eliminating things they have always enjoyed, and become focused on good or bad foods, healthy or unhealthy foods, or safe and unsafe foods. For some, choosing a vegan or vegetarian diet can be a way of removing a number of food groups and, again, can be a source of tension or confusion in those around them.

4. There may be inconsistencies in their relationship to food

Eating disorders don’t develop in a linear way and sufferers don’t always ‘fit’ one label or another. What’s more, different behaviours can appear at different times depending on the coping strategy needed. Some might find they are eating less and less, restricting food and drinks. Others may find themselves not eating for long periods, and then eating a lot, leaving them feeling uncomfortable and down. Some find themselves purging after meals or snacks, and others feel chaotic and out of control around food, engaging a mixture of these behaviours. Family members may notice that the person they love is less open, more secretive, struggling to talk as freely and openly as maybe they used to. These painful and delicate signs are often a signal that all is not ok and can indicate a need to reach out for professional support.

5. You notice psychological changes

As an eating disorder develops, a person’s sense of self-worth and mood can rapidly deteriorate. They may start to constantly question themselves, with a sense of “never being good enough” creeping over them. As a defence mechanism, those in close proximity might notice that the person is becoming more verbally or physically aggressive. They may also become more recessive – not wishing to socialise, and seem easily unsettled by events around them. These are all indicators that someone is struggling and it’s important to raise your concerns accordingly.

6. Physical symptoms emerge

A clear sign of eating disordered behaviour is a change in someone’s weight. Whilst weight is by no means the only indicator of an eating disorder, a significant change in weight is important to take notice of. You may notice that someone becomes preoccupied by how they look, constantly checking a mirror or making negative comments about themselves. They may start to make comparisons between how they and others look, usually noting what they see to be their deficiencies. A person might become light-headed – on standing up from the sofa for example or seeming to struggle on the stairs. They may feel cold to the touch, have chapped lips, and look pale and tired. Hair might thin, periods can stop or become less regular for girls, and for some dental issues can arise from vomiting. These are signs that someone is nutritionally deficient and requires professional help.